=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033205315
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES SCOTT WILLIAMSON CRNA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2006
-----------------------------------------------------
Last Update Date | 09/22/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 721 E COURT ST PARIS COMMUNITY HOSPITAL
-----------------------------------------------------
City | PARIS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61944
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 217-465-4141
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 525 PRAIRIE ST
-----------------------------------------------------
City | PARIS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61944-1433
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 217-265-3146
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367500000X
-----------------------------------------------------
Taxonomy Name | Certified Registered Nurse Anesthetist
-----------------------------------------------------
License Number | R858455
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 367500000X
-----------------------------------------------------
Taxonomy Name | Certified Registered Nurse Anesthetist
-----------------------------------------------------
License Number | 209.007081
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------